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Open AccessArticle

Questionnaires for Lung Health in Africa across the Life Course

Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
Division of Pulmonology, University of Cape Town, Rondebosch 7701, South Africa
University of Cape Town Lung Institute, Cape Town 7701, South Africa
Unit of Teaching and Research in Occupational Health and Environment, University of Abomey-Calavi, Calavi, Cotonou 01 BP 526, Benin
Douala General Hospital, Department of Internal Medicine, Douala, Cameroon
Makerere University College of Health sciences; Uganda Tuberculosis implementation Research Consortium (U-TIRC), Kampala 7072, Uganda
Malawi Liverpool Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, College of Medicine, Chichiri 30096, Blantyre 3, Malawi
Epidemiological Labarotory (EpiLab) for Public Health Khartoum 3, Block 3- Building 11, Khartoum, Sudan
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(8), 1615;
Received: 9 July 2018 / Accepted: 23 July 2018 / Published: 31 July 2018
PDF [272 KB, uploaded 31 July 2018]


Respiratory infections remain a leading cause of morbidity and mortality in many low and middle-income countries but non-communicable disease rates are rising fast. Prevalence studies have been primarily symptom-focused, with tools developed in countries in the Global North such as the United States and the United Kingdom. Systematic study in sub-Saharan African populations is necessary to accurately reflect disease risk factors present in these populations. We present tools for such studies, developed as part of the International Multidisciplinary Programme to Address Lung Health and TB in Africa (‘IMPALA’), which includes lay representatives. At a preliminary meeting, the adequacy and suitability of existing tools was discussed and a new questionnaire set proposed. Individual questionnaires were developed, and an expert panel considered content and criterion validity. Questionnaires underwent a cross-cultural adaptation process, incorporating translation and contextual ‘sense-checking’, through the use of pre-established lay focus groups in Malawi, before consensus-approval by project collaborators. The complete set of research questionnaires, providing information on lung health symptoms and a relevant range of potential risk factors for lung disease, is now available online. In developing the tools, cultural and contextual insights were important, as were translational considerations. The process benefitted from a foundation in expert knowledge, starting with validated tools and internationally respected research groups, and from a coordinated collaborative approach. We present and discuss a newly devised, contextually appropriate set of questionnaires for non-communicable lung disease research in Africa that are now available in open access for all to use. View Full-Text
Keywords: lung heath; symptoms; air pollution; tuberculosis; COPD; questionnaires; cross-cultural adaptation lung heath; symptoms; air pollution; tuberculosis; COPD; questionnaires; cross-cultural adaptation
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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MDPI and ACS Style

Saleh, S.; Van Zyl-Smit, R.; Allwood, B.; Lawin, H.; Mbatchou Ngahane, B.H.; Ayakaka, I.; Moyo, E.; El-Sony, A.; Mortimer, K.; Rylance, J. Questionnaires for Lung Health in Africa across the Life Course. Int. J. Environ. Res. Public Health 2018, 15, 1615.

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